| NPI | 1942059019 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 1871101691)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 171M00000X Case Manager/Care Coordinator | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL 1992914659)  | |
| Enumeration Date | 2024-05-13 | 
| Last Update Date | 2024-05-13 |